Southland cardiac expert: Eat less, exercise more
By Karen Caffarini For Sun-Times Media
Cardiac expert: Dr. P. Sandy Sundram, medical director of Ingalls Health System’s Cardiac Program. | Supplied photo
for Women and Men
Many warning signs associated with chest pain are similar for men and women, such as fatigue, pain at rest, shortness of breath and weakness. Dizziness is the next most common symptom reported by women, whereas men report arm pain. When a women’s chest pain is related to her heart, the pain tends to be more vague than the type of chest pain men experience; back pain also is twice as common for women as for men.
Generally more likely to experience pain localized just to the left of the breastbone or in the entire upper chest.
Others have pain to the left shoulder and inside the left arm to the waist.
A common combination is pain in the mid-chest, neck and jaw.
A heart attack may reveal itself through nausea, vomiting, tightness in the chest or shortness of breath — signs that could be misinterpreted as indigestion.
Arm or shoulder pain; jaw, neck or throat pain; toothache; pain in the back, beneath the breastbone, or in the pit of the stomach.
Back pain — it’s twice as common for women as for male patients.
Vague chest pains that come and go but fail to improve with rest.
Loss of appetite and shortness of breath at night, which are significantly more common among women than among men.
Courtesy of the American Heart Association
A leading cardiologist in the Southland area is not reassured by national reports of fewer heart attacks, saying while acute heart attacks may be down both nationally and locally, the effects of chronic coronary disease are increasing.
“The single biggest problem is diabetes is on the rise. Diabetes is inter-related to heart problems,” said Dr. P. Sandy Sundram, president of Advanced Heart Group and medical director of Ingalls Health System’s cardiac program.
A toxic lifestyle
Sundram said hypertension and obesity — two other risk factors for heart disease — have become more severe problems both in the Southland and across the nation.
“Food is easy to get and calorie intake is plentiful. That is part of the problem. Another part is the decrease in the level of activity on a daily basis,” Sundram said.
He said the Southland area is similar to any urban population in the United States. There is a mix of various demographics and economic and social classes.
Sundram said he sees a lower level of awareness and general apathy toward the importance of exercise and being active.
“For every eight articles about food, I see about two on activity. Everything is done on computers; people are sedentary, driving cars to go everywhere and parking as close to the shopping center as they can. They use elevators instead of stairs when most of the people don’t need to. It’s become part of our psyche,” Sundram said.
Fixing the problem
He said people need to deal with inactivity and calorie consumption on the same level as they now do with smoking, which has resulted in a decrease in the number of smokers and smoking-related heart disease.
He said there needs to be vigorous national debate on where being overweight is taking us, but added there also needs to be a way to fix the problem.
“We can’t dispense advice without offering a way out,” he said. “There need to be social programs that increase activity.’
On the positive side, Sundram said there is always something new in the field of cardiology in both the types of devices and pills used.
“There is nothing that is similar to what we were doing 20 years ago. The field is constantly changing,” he said.
Sundram said the biggest story of the last 20 years is the use of stents.
“Stents have transformed the way we treat heart attack patients. From the time they enter the door to the time we are able to fix their problem is 90 minutes,” he said.
Sundram said stents themselves are always improving; they can be inserted in places today where he wouldn’t have dared to place them before.
He said there have been major improvements in the quality and size of defibrillators and other devices, too. He said some devices help a weak heart pump harder and some can measure the amount of water in the body, which is important for cardiologists.
The last decade also has brought about more awareness of the differences between men and women regarding heart disease. The cardiologist said on a percentage basis, women have more atypical presentations when having a heart attack besides the usual chest pain or heaviness, pain the arm or jaw, sweating and shortness of breath.
Another big difference occurs during a woman’s reproductive years, relative to men, her estrogen levels offer a certain measure of protectionm against coronary disease, he said. Also, women who are diabetic or overweight tend to have smaller arteries, which can make treatment more difficult, he said.